Paediatric Society Welcomes Folate Research Findings

22/12/2011

The Paediatric Society of New Zealand (PSNZ) welcomes the findings of MAF "Monitoring Voluntary Fortification of Bread with Folate” research released today that shows that adding folate to bread does increase the levels of folate in women of childbearing age. However, while the voluntary addition of folate is beneficial, the PSNZ strongly favours mandatory addition and calls on the government to act now, and not to further delay this important health initiative.

Dr Rosemary Marks, paediatrician and president of PSNZ says that further delay in bringing in mandatory fortification of bread will result in perhaps up to 20 preventable neural tube defect (NTD) pregnancies per year in NZ and up to 15 preventable terminations. The lifetime hospital costs alone of each child with spina bifida is about NZ$1 million, and the distress to the child and family, the lost family income and the educational and disability sector costs probably double the preventable costs to the taxpayer.

"The research shows us that folate can be added safely to bread, and when it is, the blood folate levels in the population rise. Comparing the latest research with figures from 2008/2009 show that double the number of women had red blood cell folate levels in the optimum range for preventing neural tube birth defects (NTD) like spina bifida" (from 26% to 59 % having RBC folate 906 nmol/L or above).

However, Dr Marks cautioned that the research also shows us that a highly monitored voluntary fortification programme gets us less than half-way to where we want to be in reducing NTD birth defect rates.

In the 2011 survey period, almost all women (93%) ate bread that week, but only 18% had eaten brands known to be fortified. In NZ we estimate we have around 75 NTD pregnancies a year, and any voluntary programme is going to reach less than half the people it needs to. A voluntary programme might reduce numbers of NTDs to 50, but not to the international optimum of 5 per 10000 (30 per year in NZ terms) found in countries with mandatory fortification.

In addition, folate is known to be protective of other birth defects such as congenital heart disease. Three slices of fortified bread per day is all it takes, in addition to an otherwise healthy diet.

The Paediatric Society of New Zealand remains strongly supportive of the introduction of mandatory fortification, as planned in 2009 but deferred by two years. This would bring us in line with Australia and most of the western world who have successfully introduced mandatory folate in the food chain, and are now reaping the health benefits. PSNZ calls on the government to act now, and not to further delay this important health initiative.

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